Operative gynecology : . Fig. 50.—Enormous Ovarian Cystoma, with Globular Pendulous Abdomen, and the Character-istic Emaciation. directions, the greatest prominence being around the umbilicus. The generalappearance of such an enlargement may not differ at all from that of anencysted tumor. In a fatty abdomen, if the fat is in the walls, it is oftencharacterized by the presence of creases from side to side; if it is inside the THE GYNECOLOGICAL EXAMINATION. cavity, on the omentum and mesentery, the rotundity, in the nullipara, is simplyincreased; but in the multiparous woman the walls appear fl
Operative gynecology : . Fig. 50.—Enormous Ovarian Cystoma, with Globular Pendulous Abdomen, and the Character-istic Emaciation. directions, the greatest prominence being around the umbilicus. The generalappearance of such an enlargement may not differ at all from that of anencysted tumor. In a fatty abdomen, if the fat is in the walls, it is oftencharacterized by the presence of creases from side to side; if it is inside the THE GYNECOLOGICAL EXAMINATION. cavity, on the omentum and mesentery, the rotundity, in the nullipara, is simplyincreased; but in the multiparous woman the walls appear flabby and the abdo-men flat and distended in the flanks. These changes occur commonly after themenopause. If an abdominal tumor is present under these circumstances, it. Fig. 51.—Symmetrical Circular Outline of Abdomen Characteristic of a Large Ovarian Cyst. often becomes a difficult task to make a diagnosis, and the physician may easilybe misled into concluding that there is no tumor within. The importance of knowing the normal abdomen and its variationswithin the limits of health becomes evident as we study the changes in formbrought about by tumors in the peritoneal cavity. Such a pathological enlarge-ment is either uniform over the whole abdomen or localized in some specialarea. The enlargement itself may present a uniformly convex surface, or itmay be marked by bosses and grooves. A uniform increase in the size of thewhole abdomen is only produced by tumors of the largest size, and by a case is shown in the figure of Mrs. D., who had an ovarian cyst weigh-ing 100 pounds, which I removed in Philadelphia, in May, 1887. (Fig. 50.) A symmetrical, convex surface over an abdominal tumor indicates a corre-sponding symmetry of surface of t
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
